Few things are more awkward than conversations with family and loved ones about end of life considerations. Medicare, however, believes doctors who have these discussions with their patients should be reimbursed for their time. It makes sense: as estate planning lawyers, the majority of our conversations center around those same topics, but from a legal perspective. It’s about educating oneself so that he’s making the best decisions for himself and his family.
For some time, many have believed these types of discussions should remain between family members versus part of the overall healthcare plan with a doctor or hospital. They argued the potential of “death panels” would influence a medical practitioner’s motives. Yet informing patients about what their options are is crucial if patients wish to maintain control over their care. These discussions should be viewed as more of an educational process and it should be as individual as the patient, since every situation is different. If these kinds of conversations don’t take place, and if the family is too emotionally upset, it could mean that healthcare providers ultimately decides what happens if a patient is incapacitated. No one wants that. While most of us simply don’t believe physicians would be motivated to make decisions based on the costs, the reality is, they can provide accurate information that can be used as families try to make these difficult choices.
Now, Medicare has made its announcement. It will reimburse doctors for end-of-life discussions with their patients. Most agree this is both a welcome and long-overdue development. End-of-life issues are complex and now, doctors can provide crucial information, difficult though it may be, to make educated choices. The goal is to empower patients and families. But there’s another reason this is a smart move: these discussions help establish and make known what your wishes are, so that even if you are not able to express your wishes at the time a decision is needed, they are already known.
Let’s look at it from a different perspective: Medicare’s plan comes as many patients, families and health providers are pushing to give people greater say about how they die — whether that means trying every possible medical option to stay alive or discontinuing life support for those who do not want to be sustained by ventilators and feeding tubes.
Just as clients speak openly about their estate plans, how they want their assets divided and how they want to protect their family members from unnecessary financial burdens, patients should also feel as comfortable when speaking with their healthcare professionals.
These talks can sometimes affect your financial planning efforts, as well. Just as we encourage our clients to consider long term insurance, updating their wills, preparing a living will and putting into place proper trusts, doctors can provide a truthful expectation for their patients. When it comes together as it should, it becomes a powerful plan for the future.
For more than 55 million seniors and elderly, this is sure to make a big difference.